Effects of an Assistive Technology Intervention on Older Adults with Disabilities and Their Informal Caregivers An Exploratory Randomized Controlled Trial

Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada (WBM)
American journal of physical medicine & rehabilitation / Association of Academic Physiatrists (Impact Factor: 2.2). 01/2013; 92(4). DOI: 10.1097/PHM.0b013e31827d65bf
Source: PubMed


The aim of this study was to demonstrate experimentally that an assistive technology (AT) intervention improves older AT users' activity performance and satisfaction with activity performance and decreases their caregivers' sense of burden.

This study was a delayed intervention, randomized control trial. Baseline data were collected on 44 community-dwelling AT user-caregiver dyads in Vancouver, British Columbia, and Montreal, Quebec. The primary outcome measures for AT users were the satisfaction and accomplishment scales from the Assessment of Life Habits. The primary outcome measure for caregivers was the Caregiver Assistive Technology Outcome Measure, which assessed burden associated with dyad-identified problematic activities.

After the intervention, assistance users in the immediate intervention group reported significantly increased satisfaction with activity performance (P < 0.001) and improved accomplishment scores (P = 0.014). Informal caregivers in the immediate intervention group experienced significantly decreased burden with the dyad-identified problematic activity (P = 0.013). Participants in the delayed intervention group experienced similar benefits after the intervention. Improvements for both groups were mostly maintained 4 mos after the conclusion of the intervention.

This is the first experimental study to demonstrate that the provision of AT decreases caregiver burden. If confirmed and extended by subsequent research, the findings have significant policy and practice implications and may enable health care providers to advocate for improved access to AT provision and the related follow-up services.

Download full-text


Available from: Jeffrey Jutai,
392 Reads
  • Source
    • "Assistive devices improve the ability of the user to perform activities of daily living15, 16). They also decrease users’ dependence on human assistance, especially assistance from informal caregivers, that is, friends, family, and community members who provide unpaid assistance to ill or disabled recipients17). "
    [Show abstract] [Hide abstract]
    ABSTRACT: [Purpose] The objective of this study was to determine users’ satisfaction with assistive devices, and their serviceability and effectiveness. [Methods] A random sample of 138 users participated in this study. The Korean-Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 and an additional questionnaire were used for data collection. Data were analyzed by using descriptive statistics. [Results] Overall client satisfaction was high. Respondents most commonly reported use of their device for “personal activities of daily living” and “mobility”, and considered engagement in “activities of daily living”, and “social participation” to be most desirable, respectively. [Conclusion] This study will provide rehabilitation professionals with valuable information about client satisfaction with assistive devices.
    Journal of Physical Therapy Science 04/2014; 26(4):509-12. DOI:10.1589/jpts.26.509 · 0.39 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Assistive technology is often recommended with the aim of increasing user independence and reducing the burden on informal caregivers. However, until now, there has been no tool to measure the outcomes of this process for caregivers. To describe the development of the Caregiver Assistive Technology Outcome Measure (CATOM), a tool developed to measure the impact of assistive technology interventions on the burden experienced by informal caregivers, and to undertake preliminary evaluation of its psychometric properties. Based on an existing conceptual framework, existing measures were reviewed to identify potential items in a preliminary version of the measure. Cognitive interviewing was used to identify items needing clarification. A revised CATOM and manual were then reviewed by clinicians. After revising some items based on the interview findings, the measure was piloted as part of an intervention study examining the impact of assistive technology on the users' informal caregivers (n = 44). Based on a review of 12 existing measures, a 3-part measure was developed and questions were refined based on cognitive interviews with informal caregivers and feedback experienced assistive technology practitioners. For the activity-specific and overall portions of the measure, the 6-week, test-retest intraclass correlations coefficients were 0.88 (95% CI 0.64-0.96) and 0.86 (95% CI 0.60-0.95), respectively. The CATOM data correlated as hypothesized with other measures. The CATOM is a promising measure with good content validity and encouraging psychometric properties.
    Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 03/2015; 47(5). DOI:10.2340/16501977-1952 · 1.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Older adults prefer to age in place, necessitating a match between person and environment, or person-environment (P-E) fit. In occupational therapy practice, home modifications can support independence, but more knowledge is needed to optimize interventions targeting the housing situation of older adults. In response, this study aimed to explore the accessibility and usability of the home environment to further understand adaptive environmental behaviors. Mixed methods data were collected using objective and perceived indicators of P-E fit among 12 older adults living in community-dwelling housing. Quantitative data described objective P-E fit in terms of accessibility, while qualitative data explored perceived P-E fit in terms of usability. While accessibility problems were prevalent, participants' perceptions of usability revealed a range of adaptive environmental behaviors employed to meet functional needs. A closer examination of the P-E interaction suggests that objective accessibility does not always stipulate perceived usability, which appears to be malleable with age, self-perception, and functional competency. Findings stress the importance of evaluating both objective and perceived indicators of P-E fit to provide housing interventions that support independence. Further exploration of adaptive processes in older age may serve to deepen our understanding of both P-E fit frameworks and theoretical models of aging well.
    International Journal of Environmental Research and Public Health 09/2015; 12(9):11954-11974. DOI:10.3390/ijerph120911954 · 2.06 Impact Factor